DDS Lister

For East Lansing-based dentist Brian Ruster, keeping an eye on the business of dentistry never has been more important. Despite working in a profession that, according to industry reports, was one of few to weather the recession with some bite in the past year, Ruster has had to cope with the plight of Michigan residents, customers losing dental insurance and patients taking more economical approaches when choosing procedures.

“Dentistry gets picked on all the time, whether it’s because of the economy or not,” said Ruster, a 1989 MSU graduate with an office at 1500 Watertower Place.

“It’s easy to skip an appointment for dentistry because the weather’s nice outside or something. That’s just part of our normal world. But when (General Motors Corp.) shuts down a plant, people lose their insurance.”

According to surveys by Sageworks Inc., a North Carolina-based analyst of privately held companies, the dental industry posted a 19 percent increase in profit nationwide in the past 12 months, with sales jumping 8 percent in the same time period.

The data was collected from dentists’ accountants, but a Sageworks official declined to specify how many accountants were surveyed.

In Michigan, though, the outlook for dentistry is different as the recession deepens. Ruster, for example, had a 1 percent increase in production but a decrease in collection, or the amount of money insurers paid him.

And according to the American Dental Association, or ADA, dentists nationwide are steadily feeling the effects of the recession, raising questions about Sageworks’ reports.

Nearly 52 percent of about 1,700 dentists surveyed by the ADA in February reported decreased incomes compared to previous years.

Tom Kochheiser, a spokesman for the Michigan Dental Association, said the impact of the
economic climate on Michigan dentists varies by geography.

“It sounds like, at this point, the west side of the state isn’t being hit as hard as the southeast portion of the state,” Kochheiser said.

At Olin Health Center, the number of people visiting the dental clinic is on the decline, said Kathi Braunlich, the center’s communications and planning coordinator.

From June 2007 to June 2008, patients visited the clinic 649 times for checkups, cleanings, fillings and other minor procedures.

Statistics for this year’s attendance are not yet available, but Braunlich said they are expected to be lower.

With the exception of psychiatry and physical therapy, the demand for all medical services at Olin is decreasing, Braunlich said.

“There’s a concern that possibly students are more concerned about their finances and not wanting to come in unless it’s an emergency,” she said.

In addition to revenue changes, the dental industry has seen a shift in the types of services most needed by patients.

More people have been suffering the effects of teeth grinding — jaw problems, headaches and damaged teeth — presumably because of stress generated by the poor economy and employment hardships.

Ruster said the number of people he has seen with teeth grinding problems has increased “a little bit.”

“They may have been doing it all along, but now they’re doing it more,” he said. “It’s not an easy fix.”

Also, the industry is coping with what MSU Pre-Dental Club president Brian Evanski calls “an hourglass effect,” where the demand is high for expensive procedures from well-insured patients, and demand also is high for basic procedures from uninsured patients.

“Dentistry’s either going to the side where you don’t have any coverage and need all sorts of work, or the high-end cosmetic side,” said Evanski, a nutritional sciences senior.

While many dentists might be suffering from diminished incomes, one source of those shortfalls — patients skipping dental care — could create a boom in the future when more expensive procedures, such as cavity fillings and root canals, are needed to make up for missed cleanings.

And for future dentists like Evanski, the demand for dental services will continue through the recession, if only at a slower rate.

“The recession definitely hit a lot of people and you have a lot of factory workers that had dental coverage they lost, but there’s always a need for dental work no matter what,” Evanski said.

Source:

• Michigan State News

Working, but without dental insurance, a 20-year-old Vallejo man was in such pain from a bad tooth he rushed to a hospital emergency room.

Referred to the county dental clinic, the man could not open his mouth, and was probably within days of dying from an infection, said Dr. Franklin Woo, who had him admitted into a hospital.

With such patients a regular occurrence, the dental clinic is on the front lines of the recession’s fall-out, said Woo, the county’s chief of dental services.

With the economic downturn, the county clinic is seeing an influx of people who have lost their jobs, health insurance and homes, and need dental services, Woo said.

“We have no way to meet the demand,” said Lynn Bramwell, county family health services administrator.

Some say they have nowhere else to go since most private dentists won’t see them unless they pay for services up front, Woo said.

There has been a dramatic increase in dental patients in severe pain, with cheeks swollen to the size of oranges, who are referred from emergency rooms, he said.

Two years ago, the clinic got one patient every two or three months referred from a hospital emergency room. But, these days, at least two or three come in every day, Woo said.

But while the demand is growing, the clinic is at capacity and must refer patients to private dentists or put them on a waiting list, Bramwell said.

“We are seeing a huge demand, but unfortunately we are at capacity,” Bramwell said.

“We’re having to address just the more emergent issues versus more routine or preventative care.”

Nearly 17 percent of the county dental clinic’s clients come from Vallejo and Benicia.

Some Vallejoans go for care to La Clinica Vallejo dental clinic on Sonoma Boulevard. Despite repeated calls, representatives of this organization were unavailable for Times-Herald questions.

The county also offers dental screening at homeless shelters, and for HIV patients. It accepts Medi-Cal and provides free services to the indigent while others pay on a sliding scale.

But while things are bad now, the worst of the dental crisis is yet to come, Woo said.

To deal with the state budget crisis, legislators cut funding to adult Medi-Cal dental benefits completely, which means adults on Medi-Cal payments will be unable to receive subsidized dental services.

“These people will be in dire straits,” Woo said. “If they can’t pay for the dental care, then who is going to take care of them?” Woo said.

As the county copes with increased demand, another arm of the public health department is trying to prevent tooth decay in children, a hidden epidemic, public health education manager Robin Cox said.

By the time they’re in kindergarten, 50 percent of Solano’s children have tooth decay, which increases to two-thirds by third grade, Cox said. The majority from low-income families, some children have never gotten dental care and have severe abscesses and need root canals and crowns, she said.

The county’s “Smile In Style” program aims to educate children on dental hygiene and conduct dental screening and prevention. Through clinics set up in schools, the county conducts screenings and gives children fluoride varnish and tooth sealant to prevent decay.

Dental decay is reportedly worse in Dixon, Suisun and Rio Vista, which have no fluoridated drinking water. The county dispenses fluoride mouthwash to children in these areas, Cox said.

Smile In Style began in 2006 with 4,000 youngsters and is now treating 12,000 children in kindergarten through sixth grade, Cox said.

Source:

• Times-Herald Online